Non-invasive brain stimulation in early rehabilitation after stroke

The new tendency in rehabilitation involves non-invasive tools that, if applied early after stroke, promote neurorecovery. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may correct the disruption of cortical excitability and effectively contribute to the restoration of movement and speech. The present paper analyses the results of non-invasive brain stimulation (NIBS) trials, highlighting different aspects related to the repetitive transcranial magnetic stimulation frequency, transcranial direct current stimulation polarity, the period and stimulation places in acute and subacute ischemic strokes. The risk of adverse events, the association with motor or language recovery specific training, and the cumulative positive effect evaluation are also discussed. Abbreviations: AAT = Aachen Aphasia Test, BDNF = brain-derived neurotrophic factor, IFG = inferior frontal gyrus, M1 = primary motor cortex, MRI = magnetic resonance imaging, NIBS = non-invasive brain stimulation, PET = positron emission tomography, rTMS = repetitive transcranial magnetic stimulation, SLT = speech and language therapy, STG = superior temporal gyrus, tDCS = transcranial direct current stimulation, NIHSS = National Institutes of Health Stroke Scale